How Plumpy’nuts and a Yamaha have saved Mariatou, 3, from starvation

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Usman Sowe, an outreach worker, checks his Riders for Health motorbike before heading to the village of Duwasu in The Gambia with his life-saving cargoTimes Photographer, David Bebber

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Mariatou, 3 and her sister, Sediou, who is only a year older but dwarfs herTimes photographer, David Bebber

Imre KaracsDuwasu

Last updated at 12:01AM, December 13 2012

The little girl in the yellow dress clings to the legs of her sister,
terrified of the strangers who have pushed their way in to her hut. Her name
is Mariatou. Dwarfed by Sediou, her smiling four-year-old sister munching an
orange beside her, she looks much younger than her sister. But Mariatou is
3.

By Gambian standards Duwasu is a prosperous village, set among tidy cassava
fields and mango trees that provide abundant nourishment in season. One
house at the end of the dirt track boasts a solar panel and satellite TV.
Yet even here some are starving.

Usman Sowe, the outreach health worker who is in charge of ten villages on the
verdant south bank of the River Gambia, is proud of the fact that not one of
Duwasu’s 64 under-5s has died this year, and last year only two in the age
group died.

That is a very good record — one out of ten children in The Gambia does not
reach their fifth birthday.

Mariatou herself had a close call. By the time that Usman discovered her on
one of his rounds, she was exhibiting clear signs of SAM — severe acute
malnutrition. He handed out Plumpy’nuts, a peanut-based supplement that has
already turned Mariatou into a chubby toddler, and might one day help her to
grow into a healthy child.

Usman cannot just dump several months’ supply of tasty Plumpy’nuts, however.
Mariatou’s hut has no door, and the children in the village regularly raid
her stash. So every fortnight he sets out on his Yamaha provided by the
small British charity Riders for Health to check on the sisters — Sediou is
said to be mildly under-nourished — and replenish their supplies.

Riders for Health has been chosen for this year’s Times charity
appeal.

The latest visit is a good opportunity to inspect Duwasu’s defences against
its worst scourge: malaria. Mosquito breeding grounds have not been sprayed
here for two years, but Usman’s ledger, in which malaria cases are marked
with red, paints a curious picture. The book with the names of small
children looks reassuringly blue – many ailments but not a single case of
malaria. Normally, the youngest would be expected to be the most vulnerable.
Sadly, the second volume, which lists teenagers and grown-ups, is covered in
red ink.

At his clinic in a village nearby — a bungalow behind the school with four
rooms but no electricity — Usman has a little pharmacy. It stocks vitamins,
antibiotics for the chest infections prevalent in these parts, sophisticated
anti-malaria drugs, and for pregnant women who cannot take those, quinine.
Each month Usman holds a surgery, but his real job is to prevent disease,
rather than simply dole out pills. He organises drama groups that ride out
to naming ceremonies and wedding parties, entertaining guests with plays
about hygiene and bed nets. And when he visits, he checks that the message
is getting through.

In Duwasu we are shown into the house of Modou Manneh, the village health
volunteer who is the last line of defence against disease. Both beds in his
home have impregnated nets, bearing the logo of a Swiss company, neatly
folded up and pegged back during the day. He swears his family lets them
down every night. But nets are no help for teenagers and adults who stay out
in the fields after sunset. It is they who turn Usman’s pages red.

Simple cases can be cured in the village, but those suffering from a severe
form of malaria will face a long journey in one of Riders’ ambulances to a
distant clinic with fully trained nurses, or a hospital with Cuban, Nigerian
and maybe Gambian doctors at hand. There are only five hospitals in the
whole of The Gambia, a strip of a country bisected by the mighty River
Gambia, with not one bridge across.

A patient’s chances of survival — and full recovery — have improved a great
deal since the Riders for Health charity took over the Health Ministry’s
fleet of ambulances four years ago. The vehicles no longer break down on the
way to clinic. Three times as many patients were delivered to hospital last
year than in 2010.

But The Gambia’s hospitals are best avoided. For the foreseeable future it
will be up to people such as Usman on his Yamaha 100 to tend to the majority
of the nation’s sick.

Corporate kindness

• The Vitol Foundation, longstanding supporters of Riders for Health, will
match donations up to $100,000 (£62,000) in cash.

• Silverstone Circuit will match donations to Riders for Health by donating
venue, track time and event services up to a value of £70,000.